Han Xiaoxu, Zhang Min, Dai Di, Wang Yanan, Zhang Zining, Liu Jing, Geng Wenqing, Jiang Yongjun, Takebe Yutaka, Shang Hong
Key Laboratory of Immunology of AIDS, Ministry of Health, the First Affiliated Hospital, China Medical University, Shenyang, Liaoning Province, P.R. China 110001.
AIDS Res Hum Retroviruses. 2007 Mar;23(3):357-64. doi: 10.1089/aid.2006.0094.
To examine the prevalence of drug resistance mutations among treatment-naive HIV/AIDS patients living in Liaoning province in China, the HIV-1 pol gene from plasma of 91 seropositive treatment-naive patients was amplified and sequenced. Three patients (3.3%) had an M46I amino acid substitution in the protease (PR) gene that decreased susceptibility to IDV, RTV, and NFV and one patient (1.1%) had an M184I amino acid substitution in the reverse transcriptase (RT) gene that confers high-level resistance to 3TC and FTC. Minor mutations were detected in high frequency in the PR gene. The frequencies of minor mutations to protease inhibitors (PI) were I93L (71.4%), L63P (62.6%), V77I (62.6%), M36I/V (33.0%), A71T/V (22.0%), K20R (6.6%), G16E (6.6%), and L10I (5.5%). The relatedness between subtypes and the frequencies of amino acid substitutions in PR were observed; 63P, 77I, and 71V/T were found in HIV-1 subtype B'/B, 16E, 36I, 20R/I, and 82I in non-B, except for CRF07_BC, 10I in subtype A, and 93L in non-A. Although the primary resistance of HIV-1 to antiretroviral drugs is low among the treatment-naive HIV-1 patients living in Liaoning province, the surveillance and monitoring of drug-resistant HIV-1 should be implemented regularly because of the increased access to antiretroviral therapy in China.
为了检测中国辽宁省初治HIV/AIDS患者中耐药突变的流行情况，对91例血清学阳性初治患者血浆中的HIV-1 pol基因进行了扩增和测序。3例患者（3.3%）蛋白酶（PR）基因发生M46I氨基酸替代，降低了对茚地那韦（IDV）、利托那韦（RTV）和奈非那韦（NFV）的敏感性；1例患者（1.1%）逆转录酶（RT）基因发生M184I氨基酸替代，对拉米夫定（3TC）和替诺福韦酯（FTC）具有高水平耐药。PR基因中高频检测到次要突变。对蛋白酶抑制剂（PI）的次要突变频率分别为I93L（71.4%）、L63P（62.6%）、V77I（62.6%）、M36I/V（33.0%）、A71T/V（22.0%）、K20R（6.6%）、G16E（6.6%）和L10I（5.5%）。观察到亚型与PR中氨基酸替代频率之间的相关性；在HIV-1 B'/B亚型中发现L63P、V77I和A71V/T，在非B亚型（CRF07_BC除外）中发现G16E、M36I、K20R/I和I82I，在A亚型中发现L10I，在非A亚型中发现I93L。尽管辽宁省初治HIV-1患者中HIV-1对抗逆转录病毒药物的原发性耐药率较低，但由于中国抗逆转录病毒治疗的可及性增加，应定期开展耐药HIV-1的监测。
